Could my Dog or Cat have Periodontal Disease?

Teeth are anchored in periodontal tissues consisting of gingiva (gums), ligaments, cementum, and supporting bone. More than 85% of dogs and cats older than four years have periodontal disease. Periodontal disease starts with the formation of plaque, a transparent, adhesive fluid composed of bacteria. Plaque starts forming within eight hours after a thorough dental cleaning. When plaque is not removed, mineral salts, in the saliva, precipitate forming hard calculus. Calculus is irritating to gingival tissue. By-products of the bacteria "eat away" the tooth's support structures eventually causing pain and periodontal disease.

There are two grading systems commonly used to classify the degree of periodontal disease. Mobility index evaluates tooth movement within the socket. With Class I mobility, the tooth only moves slightly. Class II describes tooth movement less than the distance of a crown width. Class III mobility occurs when there is movement greater than a crown width. Class III reflects severe periodontal disease in which the teeth have lost more than 50% of their support and usually need extraction.

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Grade 1 gingivitis, gumline inflamed

Periodontal disease can also be graded from stages one to four. The first two stages are classified as gingivitis the last two as periodontitis. In stage one, plaque extends to the gum line causing inflammation of the gingiva. Stage two gingivitis, is marked by inflammation and swelling. Gingivitis can usually be reversed by thorough teeth cleaning by a veterinarian while the dog or cat is anesthetized. If treated early, the gums can return to normal appearance and function. If untreated, periodontitis can result. Stage three periodontal disease occurs when there is bone loss in addition to gingival inflammation and infection. In stage four periodontal disease, there is a progression of the bone loss usually creating tooth mobility.

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Grade 2 gingivitis, gumline
inflamed and swolen

Once bone loss from periodontal disease has occurred, therapy more involved than routine cleaning is needed. What factors should the pet owner or breeder consider before periodontal surgery? A cooperative patient, a treatable tooth, and choice of which periodontal procedure to use. The owner of a dog or cat with periodontal disease needs to be committed to save their animal's teeth. This commitment includes daily brushing to remove plaque, which begins to build within eight hours after the previous brushing. Frequent veterinary dental re-examinations are required, and expense should be considered. The patient must also be a willing partner. If a dog or cat will not allow home care the best dental surgeon and most caring owner will not make a difference. Unless there is strong owner commitment and patient compliance, it is wiser to extract a tooth rather than letting the pet suffer.

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Grade 3 periodontal disease with bone
loss around third premolar tooth root

Choosing appropriate teeth to operate upon is equally important. Every dental procedure by a veterinarian should include probing and charting. A periodontal probe is an important instrument used to evaluate periodontal health. A probe is marked in millimeter gradations and gently inserted in the space between the gingival margin and tooth. The probe will stop where gingiva attaches to the tooth or at the bottom of the socket if the attachment is gone. Dogs without periodontal disease should have less than two millimeter probing depths and cats less than one. Each tooth should be probed on four sides. Probing depths of all teeth are noted on the dog or cat's medical record and a treatment plan formatted. Pocket depths up to five millimeters can usually be cleaned adequately with hand instruments while the patient is anesthetized. Depths greater than five millimeters need surgical care, to evaluate and clean the root surfaces, or extract the tooth.

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Grade 4 severe periodontal disease

Intraoral x-rays supply important information when deciding which tooth will benefit from surgery. X-rays help evaluate supportive bone around the teeth. As a general rule, if there is greater than 50% bone loss around a tooth, only advanced surgical procedures may provide long term success. X-rays are also examined for other pathology which should be treated prior to, and may effect the outcome of periodontal care. Once the veterinarian is convinced that he or she is working on a cooperative patient and tooth that can benefit from care, appropriate type of periodontal surgery is chosen. An ideal method allows exposure of the root surface for cleaning, preserves attached gingiva, and allows the gum to be reconnected in a fashion that eliminates the periodontal pocket.

 



This page last updated on October 31, 2000
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Jan Bellows, DVM
All Pets Dental Clinic
17100 Royal Palm Blvd.
Weston, FL 33326
(954) 349-5800
dentalvet@aol.com